Smoking and Pregnancy

Smoking and Pregnancy

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Jun 7 01 4:24 PM

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I saw yesterday where one member stated she was quitting smoking because she was planning for having a child and another post where a member actually found
out she was pregnant. While it is always paramount for long-term success in smoking cessation that the smoker focuses on the fact that he or she is quitting
for his or her own primary benefit, this is an area that a woman needs to take a little extra consideration for another life.

There are great risks posed to the unborn child if women smoke while pregnant. There is a greater risk of smaller babies, sicker babies, stillbirths, and
more death within the first year of life. Children who grow up in smoking households have more chronic colds and respiratory diseases.

I haven't researched this area for quit sometime, but I know years ago that there were some pretty strong studies that showed that if women quit smoking
during the first trimester of pregnancy, the risk of low birth weight babies were reduced back to non-smoking mothers again. It seemed at least at that time
that a good part of the danger was induced smoking past that time period.

It is important for women who are in the stage of their lives of family planning take their smoking into consideration. The idea of just quitting to get
pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time
period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.

For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased
your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to
see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly
person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with
staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve
"your" overall health and quality of life is to never take another puff!

Joel

Here is a link to the CDC fact sheet on smoking and pregnancy. There are plenty
of other sites that I am sure have similar information too. I just went for the first one that popped up in a search engine.

Your post will be a great support to anyone planning to have a baby or already pregnant. I only wish I had had this kind of information when I was pregnant
two years ago.

In January of 1999, once I realized I was pregnant, I had no trouble quitting smoking. In fact, it seemed absurbly easy. I was nicotine free all during my
pregnancy and for my three months of maternity leave while I was breastfeeding. I never felt tempted to cheat during that almost year long period. But on
the very first day on my way back to work, I stopped at a convenience store, bought a pack of smokes and never looked back.
The reason?? I hadn't yet decided to quit for MYSELF. I had only quit smoking to help ensure a healthy baby. In the back of my mind, I
think I always knew I would go back to my smoking once I was able to. Now, 20 months later, I'm finally quitting for myself.
There are a million other great reasons I'm quitting, too, but my main reason is me. Even though I've only quit for 3 weeks
and 4 days, I'm 100 times prouder of this quit than when I quit for 11 months because I'm finally doing it ME.

And as god as my witness, this quit is definitely my last.

So anyone out there quitting because you're pregnant, make sure you read Joel's post again and again and again. It sure would have save me over a
year of wasted time smoking.

About quitting while pregnant being absurdly easy. I have known numerous women who spontaneously quit smoking by literally, "losing their taste or
stomach" for smoking, only to find out days later that they were in fact pregnant. It seems some women almost have an instinctive knowledge, or at least
their bodies instinctively know that smoking and pregnancy don't mix. But it is amazing how fast the desire returns after delivery. I have had a number
of women joke with me that as soon as they delivered the baby they were asking when they could have a cigarette even before they asked what the sex of the
baby was.

Again, quitting for a baby will help for a nine-month period, but for a longer commitment, a lifelong commitment so to say you have to be quitting for
yourself. Again, while others may benefit, even your own children, you are still the primary benefactor.

Thanks for sharing your input here. To make this quit last through all the births you ever encounter, whether it be your own children, your children's
children, or all your future descendants, always remember for yourself to be smoke free for the rest of your life you must never take another puff!

Background. Many women stop smoking while they are pregnant, but the majority resume smoking in the postpartum. The objective
is to describe postpartum tobacco use of women who quit during pregnancy and factors predicting postpartum smoking relapse.

Method. Secondary analysis of two surveys of new mothers. Survey A conducted in three maternity hospitals, including 685 women
interviewed after birth and who answered a postal questionnaire at 5 months postpartum; survey B conducted in four 'départements' (administrative
areas), including 636 women who answered a postal questionnaire at 6 months postpartum. Response rates were respectively 90% and 68%. smoking status was
recorded for three time periods: before pregnancy, during pregnancy, and at 5-6 months. Social and those who had not, and among quitters, who had resumed
smoking postpartum and those who had not.

Results. In survey A, 37% were smokers before pregnancy, 34% of them stopped during pregnancy, and among the latter, 48% had
resumed smoking 5-6 months after delivery. In survey B, the percentages were respectively 43, 54 and 57%. The most predictive factor of postpartum smoking
relapse was the partner's smoking behaviour.

Conclusion. Return to smoking after delivery is frequent, but nearly half of the regular smokers who had stopped during
pregnancy were still non-smokers 5-6 months after the birth. However, to increase this proportion, interventions need to include partners, especially if they
are smokers.

Kinzismom, I'm sure your question comes as a bit strange to most here at Freedom as we fully admit that we are nicotine addicts so there is no other way
to QUIT using nicotine than to quit using nicotine. Anything else isn't quitting.

It could be that you're referring to the potential harm to the fetus from being put into withdrawal but I've yet to see any study on specifically
addressing the issue. In my last live two week clinic I had a mother who was seven months pregnant and still smoking. We spent lots of time talking about
her baby being born addicted to nicotine and spending its very first day alone on earth going through physical nicotine withdrawal but to no avail. Eleven
of 14 graduated, including her sister, but she wasn't among them. I think we all felt bad.

Sorry I didn't get to this yesterday although John has it covered already. There are people out there who will tell you that quitting cold turkey is too
hard for all people and NRT and other pharmaceutical products will lessen the impact and improve your success. But as you see at Freedom, cold turkey is not
too hard considering everyone here has pulled it off and if you talk to ex-smokers here and elsewhere who have successfully quit cold turkey and had used
other miracle products in the past--that the cold turkey quit was likely no worse and in many cases even easier than the previous pharmaceutically aided
attempts. But even most NRT advocates don't push the products to pregnant women leaving cold turkey the basic method of choice by most.

As far as being cold turkey possibly being too hard on your system--the short-term effects of withdrawal are nothing compared to the chronic assault of
nicotine and carbon monoxide on the fetus. The risks of not quitting are real and as can be seen by the article and link above, if you are worried about the
health of your baby and then your ability to be a parent to your child for a longer and healthier lifetime always remember to never take another puff!

On the subject of pregnancy, I just heard a headline on the radio this morning (in the UK) that new medical research shows that smoking has a
contraceptive effect. In the study, smoking women took on average two months longer to conceive than non-smokers. If I read any more detailed info,
I'll post it.

This is not a new revelation. Here is a Fact Sheet produced by ASH in the
United Kingdom. (Your hometown )

FACT SHEET NO. 7

July 2001

SMOKING, SEX & REPRODUCTION

Introduction

Cigarette smoking can affect women's fertility; men's fertility; sexual function in men; pregnant women's health; the health of an
unborn child; and the health of young children.

Fertility

Women who smoke may have reduced fertility. One study found that 38% of non-smokers conceived in their first cycle compared with 28% of smokers.
Smokers were 3.4 times more likely than non-smokers to have taken more than one year to conceive. It was estimated that the fertility of smoking women was
72% that of non-smokers.[1] A recent British
study found that both active and passive smoking was associated with delayed conception.[2]Cigarette smoking may
also affect male fertility: spermatozoa from smokers has been found to be decreased in density and motility compared with that of non-smokers.[3]

Male sexual impotence

Impotence, or penile erectile dysfuntion, is the repeated inability to have or maintain an erection. One US study of men between the ages of 31 and
49 showed a 50% increase in the risk of impotence among smokers compared with men who had never smoked.[4]Another US study, of
patients attending an impotence clinic, found that the number of current and ex-smokers (81%) was significantly higher than would be expected in the general
population (58%).[5]

Overall smoking increases the risk of impotence by around 50% for men in their 30s and 40s. ASH and the British Medical Association have calculated
that around 120,000 UK men in this age group are needlessly impotent as a result of smoking.[6]

Smoking and oral contraceptives

For younger women, smoking and the use of oral contraceptives increases the risk of a heart attack, stroke or other cardiovascular disease by
tenfold. This effect is even more marked in women over 45.[7] It is therefore important that all women who take the contraceptive pill be advised
not to smoke.

Smoking and pregnancy

Approximately one-quarter of pregnant women in the UK smoke. Women who smoke in pregnancy are more likely to be younger, single, of lower
educational achievement and in unskilled occupations. The male partner is more likely to smoke. Only one in four women who smoke succeed in stopping at
some time during pregnancy. Almost two-thirds of women who succeed in stopping smoking in pregnancy restart again after the birth of their
baby.[8] In December 1998, the Government set a target to reduce the percentage of women who smoked during
pregnancy from 23% to 15% by the year 2010, with a fall to 18% by 2005.[9] This will mean
approximately 55,000 fewer women in England who smoke during pregnancy.

Foetal growth and birth weight

Babies born to women who smoke are on average 200 grams (8 ozs) lighter than babies born to comparable non-smoking mothers. Furthermore, the more
cigarettes a woman smokes during pregnancy, the greater the probable reduction in birth weight. Low birth weight is associated with higher risks of death
and disease in infancy and early childhood. The adverse effects of smoking in pregnancy are due mainly to smoking in the second and third trimesters.
Therefore, if a woman stops smoking within the first three months of pregnancy, her risk of having a low‑weight baby will be similar to that of a non-smoker.
8

Spontaneous abortion

The rate of spontaneous abortion (miscarriage) is substantially higher in women who smoke. This is the case even when other factors have been taken
into account.8

Other complications of pregnancy

On average, smokers have more complications of pregnancy and labour which can include bleeding during pregnancy, premature detachment of the
placenta and premature rupture of the membranes.[10] Some studies have
also revealed a link between smoking and ectopic pregnancy 10 and congenital defects in the offspring of
smokers.[11]

Perinatal mortality

Perinatal mortality (defined as still‑birth or death of an infant within the first week of life) is increased by about one-third in babies of
smokers. This is equivalent to approximately 420 deaths per year in England and Wales. The increased perinatal mortality in smoking mothers occurs
particularly among manual socio-economic groups and in groups that are already at high risk of perinatal death, such as older mothers or those who have had a
previous perinatal death. More than one-quarter of the risk of death due to Sudden Infant Death Syndrome (cot death) is attributable to maternal smoking
(equivalent to 365 deaths per year in England and Wales).8

Passive smoking and pregnancy

Exposure by the mother to passive smoking has also been associated with lower birth weight, a higher risk of perinatal mortality and spontaneous
abortion.[12]

Breast feeding

Research has shown that smoking cigarettes may contribute to inadequate breast milk production. In one study, fat concentrations were found to be
lower in the milk from mothers who smoked and milk volumes were lower.[13]

Health and long‑term growth

Infants of parents who smoke are twice as likely to suffer from serious respiratory infection than the children of non-smokers. (See also Fact Sheet No. 8, Passive Smoking.) Smoking in pregnancy may also have
implications for the long term physical growth and intellectual development of the child. It has been associated with a reduced height of children of
smoking mothers as compared with non-smoking mothers, with lower attainments in reading and mathematics up to age 16 and even with the highest qualification
achieved by the age of 23.[14] One study has demonstrated a link between maternal smoking during pregnancy and adult male
crime.[15]There is also evidence that smoking interferes with women's hormonal balance during pregnancy
and that this may have long-term consequences on the reproductive organs of her children.[16]

Smoking and cervical cancer

Epidemiological studies have found that women who smoke have up to four times higher risk of developing cervical cancer than non-smokers and that
the risk increases with duration of smoking. Studies have demonstrated biochemical evidence that smoking is a causal factor in cervical
cancer.[17][18]

Smoking and the menopause

The natural menopause occurs up to two years earlier in smokers. The likelihood of an earlier menopause is related to the number of cigarettes
smoked, with those smoking more than ten cigarettes a day having an increased risk of an early menopause.[19] New research
suggests that polycyclic aromatic hydrocarbons found in tobacco smoke can trigger premature egg cell death which may in turn lead to earlier
menopause.[20]

One way to reduce the risk of having a colicky baby is not to smoke during pregnancy.

When Danish researchers at Aarhus University Hospital studied 1,820 women and their newborns, they found that women who smoked 15 or more cigarettes per
day during pregnancy were twice as likely to have a colicky baby than mothers who didn't smoke.

About 1 of 10 infants are colicky at birth, a condition marked by excessive crying that usually subsides by the age of 3 or 4 months.

Prenatal smoking is known to inhibit fetal growth, and it may be that it promotes colic by delaying the development of the central nervous system, Dr.
Charlotte Sendergaard reported in Pediatrics, a journal of the American Academy of Pediatrics.

Studies have shown nicotine is excreted into maternal milk, so that suckling offspring would be a target of the drug during the pre-weaning period. Since
nicotine exposure leads to an upregulation of neuronal nicotinic receptors, this study examines the hypothesis that nicotine delivered via maternal milk is
capable of altering neuronal nicotinic receptor regulation in the drug-exposed rat pups. The present study showed that postnatal nicotine exposure via
maternal milk was sufficient to induce an upregulation in brain nicotinic receptors similar to that seen in adults that smoke. Such exposure may result in
altered neuronal development and synaptic activity and structure, potentially leading to long-term behavioral, learning, and memory deficits.

NEW YORK (Reuters Health) - Nicotine exposure in the womb, even in the absence of other substances present in tobacco smoke, may lead to
breathing difficulties in newborns, results of an animal study suggest.

The findings indicate that nicotine can have lasting harmful effects on developing fetal lungs, according to Dr. Hakan Sundell and colleagues
of Vanderbilt University School of Medicine in Nashville, Tennessee.

"The issue is of clinical significance, because nicotine replacement for pregnant women is often regarded as a safe alternative in smoking
cessation programs," they write in the American Journal of Respiratory and Critical Care Medicine.

The study involved a group of lambs that were exposed during their last trimester in the womb to nicotine through pumps that had been implanted
in their mothers. The level of nicotine was equivalent to what a human fetus would be exposed to if a pregnant woman smoked mildly to moderately, the report
indicates. A second group of lambs was not exposed to nicotine.

For a 5-week period after the lambs were born, various lung function tests showed that the animals exposed to nicotine in the womb had faster
and more shallow breathing than those that had not been subjected to nicotine, according to the report.

"Prenatal nicotine exposure appears to have long-term effects on the postnatal breathing pattern, suggesting altered lung function,"
Sundell and colleagues write. "These changes are most marked close to birth but persist during the initial postnatal period."

Nicotine easily passes through the human placenta to a developing fetus, the researchers point out. And concentrations of nicotine in the fetus
can be equal to or higher than in the mother, they add.

SOURCE: American Journal of Respiratory and Critical Care Medicine 2002;166:92-97.

BERLIN (Reuters Health) - Italian researchers have found a possible explanation for why exposure to cigarette smoke during pregnancy may increase a
baby's risk of sudden infant death syndrome or SIDS.

In a study presented here at the European Society of Cardiology annual conference, Professor Alessandro Mugelli from the University of Florence and
colleagues found that exposing rats to carbon monoxide, a component of cigarette smoke, can interfere with the maturation of heart cells in the developing
fetus.

"We found that there is an alteration which may explain the link between smoking and SIDS, so the message is, don't smoke if you are pregnant, and
don't smoke in a room where there is a baby," Mugelli said.

The researchers exposed pregnant rats to carbon monoxide at a concentration of 150 parts per million, which simulates the levels experienced by a cigarette
smoker.

The exposure delayed the maturation of some properties in heart cells that affect the QT interval. The QT interval is one portion of an electrocardiogram,
or ECG, the tracing of the heart's electrical activity.

Babies who have a long QT interval have a higher risk of irregular heartbeats, and this may predispose these newborns to sudden death, Mugelli said.

"We knew that smoking is a risk-factor for SIDS, but we didn't know the mechanism," Mugelli told Reuters Health.

SIDS is the most common cause of death among newborns, Mugelli said. Placing a baby on his or her stomach rather than the back to sleep can greatly increase
the risk of SIDS. Overheated rooms, secondhand smoke and fluffy bedding are also a risk.

Have there been any studies on nicotine in mother's milk? Several months ago, we had a conversation about how quickly we became addicted, and tried to
informally relate that to whether or not our mothers smoked. Reading another post here, it occurred to me that perhaps nicotine could (?) be transferred
through breast milk, and that perhaps children of mothers who smoke become more susceptible to rapid addiction than others because of this?

Mmmmm, Bob, being a nursing mother I've researched this as much as I could (at first to justify continuing smoking, and then to educate myself and
motivate myself to quit) and there have been some studies on breastmilk and smoking, but I think I've only seen one long-term study done to show how
easily a child is addicted later in life. There are some real problems with all of the variables; the level of consumption, the exposure of the infant to
second-hand smoke (whether in the air or on clothes), smoking in pregnancy, and the constantly changing nature of breastmilk. I know Le Leche League states
that a consumption of 15 per day is fine, and this is based on not smoking AROUND your child. However, so many studies don't take into consideration
whether or not the mother DOES smoke outside or not.

Anyway, you're aware of all this already, I'm sure, but I'm curious...am I allowed to post links to outside sites here?